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Updated: Dec 13, 2025
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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
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Does difference in stem design affect accuracy of stem alignment in total hip arthroplasty with a CT-based navigation
Ichiro Nakahara1, Takayuki Kyo2, Yasuo Kuroda3
1Department of Orthopaedic Surgery, National Hospital Organization, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 5400006, Japan. ichiro-n@umin.net.
Summary
Computed tomography (CT)-based navigation improves femoral stem alignment accuracy in total hip arthroplasty (THA). Anatomic stem designs offer superior precision compared to tapered wedge stems when using navigation.
Area of Science:
- Orthopedic surgery
- Medical imaging
- Biomechanical engineering
Background:
- Accurate femoral stem positioning is crucial for total hip arthroplasty (THA) outcomes.
- The effectiveness of computed tomography (CT)-based navigation and the impact of femoral stem design on insertion accuracy remain unclear.
Purpose of the Study:
- To compare the accuracy and precision of femoral stem alignment using two different stem designs (tapered wedge vs. anatomic) with and without a CT-based navigation system.
Main Methods:
- Retrospective analysis of 189 total hip arthroplasties (THAs).
- Comparison of planned versus postoperative stem anteversion between navigation and non-navigation groups for both tapered wedge and anatomic stems.
- Evaluation of accuracy (mean absolute difference) and precision (95% limits of agreement).
Main Results:
- Navigation groups showed significantly superior accuracy and precision for stem anteversion compared to non-navigation groups.
- Anatomic stem groups demonstrated significantly better accuracy and precision than tapered wedge stem groups, particularly within the navigation group.
- Specific accuracy and precision values were reported for each stem design and navigation status.
Conclusions:
- CT-based navigation enhances the accuracy and precision of achieving intended femoral stem anteversion in THA.
- Anatomic stem designs provide superior accuracy and precision for stem anteversion compared to tapered wedge designs, especially when utilized with navigation.
